超声乳化白内障吸除术后中央及中间带角膜变化分析

Analysis of corneal changes of central and middle zone after phacoemulsification cataract surgery

[目的]比较超声乳化白内障吸除术术前与术后的中央及中间带角膜内皮细胞计数和厚度,评估超声乳化白内障吸除术后引起的视线区域角膜损伤程度.[方法]随机选择2012年5月至12月行超声乳化白内障吸除联合人工晶状体植入术的患者52例(60眼),术前及术后2个月采用SP-2000P非接触角膜内皮计和OrbscanⅡ角膜地形图检测角膜中央及距中心3mm处的上方、下方、鼻侧及颞侧角膜内皮细胞计数及角膜厚度.[结果]超声乳化白内障吸除术前中央与中间带角膜内皮细胞计数比较差异无统计学意义(P>0.05).术后2个月中央部及颞侧中间带角膜内皮细胞计数较术前显著降低(P=0.034,P<0.001),颞侧中间带角膜厚度较术前显著增厚(P=0.041).[结论]中央角膜内皮细胞计数不能完全评估整体角膜的损伤程度,检测中央及中间带不同区域的角膜内皮细胞计数与厚度变化,可有效地评估白内障超声乳化手术对整个视线区域角膜的损伤程度.

OBJECTIVE To compare the corneal endothelial cell count and thickness in central and middle zone before and after phacoemulsification, and to assess the corneal damage degree of sight area after phacoemulsification. METHODS 60 eyes in 52 patients with phacoemulsification combined with intraocular lens implantation were randomly selected from May to December, 2012, and the corneal endothelial cell count and thickness in corneal center and above, below, nasal and temporal side from 3 mm of corneal center were examined by Orbscan II corneal topography system and specular microscope at preoperation and 2 month of postoperation. RESULTS The corneal endothelial cell count between corneal central and middle zone before phacoemulsification had no statistically significant （P〉0.05）, and as compared with preoperation, the corneal endothelial cell count in corneal center and temporal side of middle zone decreased significantly at 2 month of postoperation （P〈0.01）, and the corneal thickness in temporal side of middle zone increased significantly （P 〈 0.05）. CONCLUSION The corneal endothelial cell count in central zone can not completely assess the holistic corneal damage degree, and to detecting the corneal endothelial cell count and thickness in central and middle different zones could effectively evaluate the corneal damage degree of whole sight area for phacoemulsification cataract surgery.